The Magerl distal metatarsal osteotomy in the treatment of hallux valgus

The distal metatarsal osteotomy according to Magerl allows correction of a hallux valgus deformity by lateral and plantar displacement as well as by pronation and varisation. The length of the first metatarsal can be adjusted by the depth of the cut at the resection or by a slightly oblique osteotomy. If necessary, soft tissue release and/or a osteotomy of the first proximal phalanx can be done to relocate the sesamoids under the head of the first metatarsal. A review of 118 foot operations in 75 patients demonstrated a very good or good result in about 75 %. Radiological examination showed sufficient lateralisation of the metatarsal head. Evaluating the length of the first metatarsal and the amount of variation, the results were less satisfying. The metatarsophalangeal angles could be corrected by 14 degrees and the intermetatarsal angles by 7 degrees on average. The sophisticated operative procedure limits the use of this technique as a standard procedure.